ArticlePloS one2020
Impact of a teacher-led school handwashing program on children's handwashing with soap at school and home in Bihar, India.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 34 citations in OpenAlex.
- A cluster-randomised controlled equivalence trial of the Surprise Soap handwashing intervention among older children living in a refugee settlement in Sudan.BMJ global health · 2023Trial
- Train-the-trainer model in public health practice: Feasibility of senior nursing students as catalysts for hand hygiene education in school-aged children.Journal of family medicine and primary care · 2026Article
- Effectiveness of the newly designed WASH implementation strategy on WASH practices, diarrheal diseases, respiratory illness, and absenteeism among ashram school children.Journal of family medicine and primary care · 2025Article
- Examining the psychosocial drivers of handwashing behaviour among school children.Health psychology and behavioral medicine · 2024Article
- Article
- Nongovernmental Organization Practitioners' Perspectives on the Challenges and Solutions to Changing Handwashing Behavior in Older Children: A Qualitative Study.Global health, science and practice · 2023Article
- Handwashing Practices and Associated Factors Among School Children in Kirkos and Akaki Kality Sub-Cities, Addis Ababa, Ethiopia.Environmental health insights · 2023Article
- What are the barriers and facilitators to community handwashing with water and soap? A systematic review.PLOS global public health · 2023Article
- Do Right, Be Bright: A Protocol on the Development of an Inter-Professional Health Intervention Model for Pre-School Children Through a Community-Based Service-Learning Initiative.Journal of multidisciplinary healthcare · 2023Article
- Association between Handwashing Behavior and Infectious Diseases among Low-Income Community Children in Urban New Delhi, India: A Cross-Sectional Study.International journal of environmental research and public health · 2021Article
- The potential of school-based WASH programming to support children as agents of change in rural Zambian households.BMC public health · 2021Article
- A cross-sectional survey assessing the influence of theoretically informed behavioural factors on hand hygiene across seven countries during the COVID-19 pandemic.BMC public health · 2021Article
- Kenyan school book knowledge for water, sanitation, hygiene and health education interventions: Disconnect, integration or opportunities?International journal of hygiene and environmental health · 2021Article
- Handwashing Knowledge, Attitudes, and Practices among Students in Eastern Province Schools, Saudi Arabia.Journal of environmental and public health · 2021Article
- A comic-based body image intervention for adolescents in semi-rural Indian schools: A randomised controlled trial.International journal of clinical and health psychology : IJCHPArticle
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Handwashing with soap is an important preventive health behavior, and yet promoting this behavior has proven challenging. We report the results of a program that trained teachers to deliver a handwashing with soap behavior change program to children in primary schools in Bihar, India. Ten intervention schools selected along with ten nearby control schools, and intervention schools received the "School of Five" program promoting handwashing with soap using interactive stories, games, and songs, behavioral diaries to encourage habit formation, and public commitment. Households with children aged 8-13 attending the nearby school were enrolled in the study. Handwashing with soap was measured using sticker diaries before eating and after defecation 4 weeks after the intervention was completed. Children in the treatment reported 15.1% more handwashing with soap on key occasions (35.2%) than those in the control group (20.1%) (RR: 1.77, CI: (1.22, 2.58), p = .003). There was no evidence that handwashing with soap after defecation was higher in the treatment group than the control group (RR: 1.18, CI: (0.88, 1.57), p = .265), but there was strong evidence that handwashing with soap was greater in the treatment than in the control before eating (RR: 2.68, 95% CI: (1.43, 5.03), p = .002). Rates of handwashing increased both at home (RR: 1.63, CI: 1.14, 2.32), p = .007) and at school (RR: 4.76, 95% CI: (1.65, 17.9), p = .004), though the impact on handwashing with soap at key occasions in schools was much higher than at home. Promoting handwashing with soap through teachers in schools may be an effective way to achieve behavior change at scale.
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